Abstract:

To evaluate the extent and distribution of focal fibrosis by delayed contrast-enhanced magnetic resonance imaging (DCE MRI) in patients with severe left ventricle hypertrophy caused by genetically determined hypertrophy cardiomyopathy (HCP) and compare it with global and regional myocardial function. 15 patients with HCP were studied using 1,5 T MR-scanner (Avanto, Siemens Medical Solution). 80% patients with HCP had foci of delayed CE, which were predominantly located in the anteroseptal. 33% patients with HCP had foci of perfusion defects. Septal walls with DCE foci were significantly thicker than non-enhanced segments (19,0±6,4 and 10,6±4,7, p < 0,001). Significant correlations were observed between end-diastolic segment's thickness and extent of DCE (r = 0,26, p < 0,05). Significant reverse correlation was found between extent of contrast enhancement and stroke volume in patients with HCP (r = -0,57, r < 0,05). Mean volume DCE regions was 18,4±8,5 cm3 (Mean±SE), maximum volume of hyperenhanced area was 127,9 cm3. Abnormal signal intensity from first-pass myocardial perfusion correlates with the delayed enhancement foci in patients with HCM. The extent of focal scarring in patients with HCP may reflect the severity of myocardial damage associated with the regional hypertrophy and hypokinesia of these segments.

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Abstract:

For long time the only method of postinfarction myocardial «scars» topical diagnostics was ECG. Contrast-enhanced magnetic resonance (CE-CMR) is considered to be a highly informative technique for location and quantification of myocardial necrotic areas, but there are few studies comparing the method with conventional ECG. CE-MR/ECG correlation was studied in 59 patients with postinfarction changes. The global concordance between CE-MR and ECG was of 80%. In 5 cases (1 - anterolateral, 2 - inferior and 2 - inferolateral). ECG-pattern was misleading.

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